有氧运动对中老年人不同部位骨密度影响的系统评价与Meta分析

Systematic Review and Meta-Analysis of the Effects of Aerobic Exercise on Bone Mineral Density in Different Body Parts of Middle-Aged and Elderly Adults

摘要

通过系统评价有氧运动对中老年人不同部位骨密度(BMD)的影响，从而为中老年人制定针对性运动处方、减少骨量流失和预防骨质疏松提供科学依据。系统检索 PubMed、Web of Science、Cochrane Library、Embase、CNKI、万方数据库和中国生物医学数据库(CBM)从建库至 2025 年 12 月 20 日收录的相关随机对照试验，并采用 RevMan 5.4 软件进行 Meta 分析。最终纳入 10 篇文献，共 917 名受试者。结果显示，与对照组相比，试验组腰椎骨密度(MD=0.02，95%CI:0.01~0.03，P=0.0005)、股骨颈骨密度(MD=0.02，95%CI:0.00~0.0400，P=0.0400)和全身骨密度(MD=0.02，95%CI:0.01~0.03，P=0.0040)均显著提高；而大转子骨密度(MD=0.01，95%CI:-0.01~0.03，P=0.35)与髋部骨密度(MD=0.00，95%CI:-0.01~0.01，P=0.9100)的差异无统计学意义。上述结果表明，有氧运动能有效改善中老年人腰椎、股骨颈及全身骨密度，对承重部位和全身骨骼产生积极影响，但对大转子和髋部骨密度的改善效果尚不明确，提示干预效应存在部位特异性。

Abstract

This study systematically evaluated the effects of aerobic exercise on bone mineral density (BMD) at different skeletal sites in middle-aged and elderly adults, and aimed to provide scientific evidence for formulating targeted exercise prescriptions, reducing bone loss and preventing osteoporosis. All relevant randomized controlled trials published from the inception of each database to December 20, 2025 were retrieved from PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang Database and China Biomedical Literature Database (CBM). Meta-analysis was conducted using RevMan 5.4 software, and a total of 10 eligible studies involving 917 participants were included. The results showed that compared with the control group, aerobic exercise interventions significantly increased the BMD of the lumbar spine (MD =0.02, 95%CI:0.01~0.03, P=0.0005), femoral neck (MD=0.02, 95%CI:0.00~0.0400, P=0.0400) and total body (MD=0.02, 95%CI:0.01~0.03, P=0.0040). By contrast, no statistically significant differences were found in the BMD of the greater trochanter (MD=0.01, 95%CI:-0.01-0.03, P =0.3500) and hip (MD =0.00, 95%CI:-0.01~0.01, P =0.9100). In conclusion, aerobic exercise can effectively improve the BMD of the lumbar spine, femoral neck and total body in middle-aged and elderly adults, which exerts positive effects on weight-bearing bones status and overall skeletal health. However, aerobic exercise has no definite improvement effect on the BMD of the greater trochanter and hip, suggesting that the regulatory effect of aerobic exercise on bone density is site-specific.

关键词

有氧运动 / 骨密度 / 骨质疏松 / 中老年人 / Meta分析

Key words

aerobic exercise / bone density / osteoporosis / middle-aged and elderly adults / Meta-analysis

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基金资助

国家社科基金重大项目(21&ZD341)

教育部人文社会科学基金项目(24YJCZH145)

闽南师范大学研究生教育教学改革项目(YJG202512)